Friday, September 25, 2009

Health Insurance Memorial, Washington D.C.

On Thursday evening I paid a visit to the Health Insurance Memorial on the Mall in Washington D.C.

When I asked one of the organizers whether the building of this monument had been covered by American television  news networks or newspapers, he shook his head.

"So far only a couple foreign journalists have shown any interest in this," he said.

I was shocked to hear this.  All Americans should see to this monument.  Those who visit it should bring flowers.

Because the Health Insurance Memorial bears witness to a national tragedy of historic proportions -- one that has cost more American lives than any military conflict since World War II. 

At this new memorial people can pay their respects to the 44,840 Americans who die annually in the United States due to lack of health insurance.  The new monument is located on the Mall between the Washington Monument and the White House.   

Several thousand small US flags (each representing 10 deaths) have been arranged in 50 rows -- there is one row for each state.  So many people die annually due to lack of health insurance in Texas (5,302 deaths/ 530 flags) and California (4,675 deaths/ 468 flags) that these two rows stretch far beyond the others.  Although California has a larger population, thirty percent of Texans lack health insurance -- the highest figure for any state.  Texas is where the most Americans die unnecessarily for want of health insurance coverage.

Volunteers have been pounding little American flags into the ground since Monday.   As of Thursday night, they still had half a dozen rows of flags left to plant.  The exhibit is scheduled to remain until Sunday September 27.

The source for the 44,840 figure (for the number of American deaths caused by lack of health insurance) is Health Insurance and Mortality in U.S. Adults (abstract) published in the current issue of the American Journal of Public Health.  It's findings are based on CDC data.  A 1993 study, Health Insurance and Mortality, found a 25% higher risk of death among uninsured compared with the insured. Using the more recent CDC data, the Harvard-based researchers found that the uninsured are 40% more likely to die than the insured. This translates to 44,840 avoidable deaths per year.

Study co-author Dr. Steffie Woolhandler told R. Mokhiber writing in Counter Punch:
“The whittled down version that Senator Max Baucus is proposing would leave 25 million uninsured. That translates into about 25,000 deaths annually from lack of health insurance. Absent the $400 billion in savings you could get from a single payer system, universal coverage is unaffordable. Politicians in Washington are protecting insurance industry profits while sacrificing American lives.”
The Physicians for a National Health Program, the group that designed the memorial, is calling for a single-payer system -- as is found in almost all other developed countries.  They note the following:
  • Administrative costs consume 31% of US health spending:
  • Half of all bankruptcies are caused by medical bills
  • Taxes already pay for 60% of US health spending (the highest health care taxes in the world!).
  • The uninsured do not receive all the medical care they need -- they live sicker and die younger.
  • The US could save enough on administrative costs with a single payer system -- over $350 billion annually -- to cover all the uninsured.
It sounds as if America's deadly health insurance companies need to be laid to rest.  The sooner the better.

Pictured in the first and second photos is Jackson Bey, a client advocate with "Health Care for the Homeless" in Baltimore.

See next post.


  1. I apologize for the long comment. I have reservations about those numbers you provided, and this is too important to not at least discuss them.

    First, the authors of the second study noted some problems that they couldn't explain, or didn't address. From the Discussion section: "In fact, the increased likelihood of uninsurance among Mexican Americans who were nonetheless no more likely to die than non-Hispanic Whites might also be expected to reduce our power compared with the earlier

    And then from the Limitations section: "Earlier population-based surveys that did validate insurance status found that between 7% and 11% of those initially recorded as being uninsured were misclassified(13). If present, such misclassification might dilute the true effect of uninsurance in our sample.”

    The race thing bears looking into before firm conclusions can be made. Also, (and I might sound like a crank here) if the authors can't even be sure that the uninsured people they studied were uninsured, using their numbers is highly problematic. The fact that this limitation is in their own study is important.

    I also wonder about the numbers of actual deaths. First, 44,840 is an estimate, based on the above researched trends, not an actual figure. Assuming that their study is highly accurate, no one, as far as I know, has studied actual deaths for people who died from underinsurance – though I'm not up on this subject like you, so feel free to set me straight about this.

    As far as I can tell, from the Counter Punch quote and from your 44,840 number, the number of deaths is arrived at by dividing the total number of uninsured by 1000. But if the 44,840 figure is arrived at from a number similar to the 46 Million figure Obama used, there are problems with that as well.

    A Blue Cross/Blue Shield study (, using census numbers, found that 14 million Americans are eligible for existing government programs but simply have not signed up. They further found that an additional 13.2 million uninsured make $50,000 a year or more, and that the fastest growing segment of this population makes $75,000, or more, a year.

    There are ways to look at this from both sides, but the possibility that over half of the people Obama mentioned will not be helped by new government programs needs to at least be mentioned.

    This isn't to say that thousands of people dying from a lack of access to medical coverage is acceptable. But these problems do call into question the magnitude of the problem, as well as the need for the policies currently o the table. Real problems deserve a discussion of the real facts if they are to be solved.

  2. J-P,

    They further found that an additional 13.2 million uninsured make $50,000 a year or more, and that the fastest growing segment of this population makes $75,000, or more, a year.

    That's plausible. The health insurance industry has put the screws to the middle class, even Americans with decent incomes find themselves unable to afford the high premiums. This is particularly the case with respect to small business owners, the self-employed, and those with pre-existing conditions (who can't get coverage at all).

    They way health insurance companies make money is by NOT providing coverage to the people who are likely to need it. (The most expensive patients get covered by the government -- often when their condition has become expensive to treat -- so the health insurance profits remain high!)

    The system costs too much, provides too little for too few, and serves worst the people who need -- and very often deserve -- health care the most.

  3. No arguments from me about the costs. I'm firmly in the "I want to pay less" camp when it comes to healthcare.

    But based on the numbers I saw, I disagree with this group when they advocate a single-payer plan. I can think of more targeted ways of insuring these people that don't create more government.

  4. I can think of more targeted ways of insuring these people that don't create more government.

    While keeping the rest of the system the way it is? The country can't afford that.


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